Hearnshaw H M, Harker R M, Cheater F M, Baker R H, Grimshaw G M
Centre for Primary Health Care Studies, University of Warwick, Coventry CV4 7AL, UK.
Qual Health Care. 2001 Sep;10(3):173-8. doi: 10.1136/qhc.0100173...
To identify the desirable characteristics of review criteria for quality improvement and to determine how they should be selected.
Review criteria are the elements against which quality of care is assessed in quality improvement. Use of inappropriate criteria may impair the effectiveness of quality improvement activities and resources may be wasted in activities that fail to facilitate improved care.
A two round modified Delphi process was used to generate consensus amongst an international panel of 38 experts. A list of 40 characteristics of review criteria, identified from literature searches, was distributed to the experts who were asked to rate the importance and feasibility of each characteristic. Comments and suggestions for characteristics not included in the list were also invited.
The Delphi process refined a comprehensive literature based list of 40 desirable characteristics of review criteria into a more precise list of 26 items. The expert consensus view is that review criteria should be developed through a well documented process involving consideration of valid research evidence, possibly combined with expert opinion, prioritisation according to health outcomes and strength of evidence, and pilot testing. Review criteria should also be accompanied by full clear information on how they might be used and how data might be collected and interpreted.
The desirable characteristics for review criteria have been identified and will be of use in the development, evaluation, and selection of review criteria, thus improving the cost effectiveness of quality improvement activities in healthcare settings.
确定质量改进审查标准的理想特征，并确定应如何选择这些标准。
审查标准是在质量改进中评估医疗质量的要素。使用不适当的标准可能会损害质量改进活动的有效性，并且在无法促进改善医疗的活动中可能会浪费资源。
采用两轮改进的德尔菲法，在38名国际专家组成的小组中达成共识。从文献检索中确定的40条审查标准特征清单分发给专家，要求他们对每条特征的重要性和可行性进行评分。还邀请了对清单中未包含的特征提出意见和建议。
德尔菲法将基于文献的40条审查标准理想特征的综合清单细化为更精确的26项清单。专家们的共识观点是，审查标准应通过一个有充分记录的过程来制定，该过程包括考虑有效的研究证据，可能结合专家意见，根据健康结果和证据强度进行优先级排序，并进行试点测试。审查标准还应附带关于如何使用它们以及如何收集和解释数据的完整清晰信息。
已确定审查标准的理想特征，这些特征将用于审查标准的制定、评估和选择，从而提高医疗保健环境中质量改进活动的成本效益。
